Version 1.8, revision planned in 2012.
Last revised in June 2008
September 2010 — minor update. Additional advice about the risk of using NSAIDs in people with hepatic impairment has been added. Issued in September 2010.
June to July 2010 — updated to include more detailed advice on contraindications and monitoring of people with co-morbidities taking NSAIDs. The Supporting evidence section on the thrombotic risks associated with using NSAIDs has also been updated. Issued in August 2010.
January 2010 — advice on safety of NSAIDs during conception, pregnancy, and breastfeeding has been updated. Issued in January 2010.
December 2009 — minor update. Clarification that selective serotonin reuptake inhibitors are associated with an increased risk of bleeding, and should be avoided if a person is taking an NSAID, if possible, in line with NICE guidance Depression in adults with a chronic physical health problem [NICE, 2009]. Issued in December 2009.
August 2009 — minor update. Clarification that the National Institute for Health and Clinical Excellence (NICE) advise that proton-pump inhibitors (PPIs) should routinely be co-prescribed for anyone with osteoarthritis or rheumatoid arthritis, and anyone 45 years of age and older with chronic low back pain. Issued in August 2009.
May 2009 — the Supporting evidence section on the Risk of cardiorenal adverse events has been updated with an additional case-control study that was highlighted by the Medicines and Healthcare products Regulatory Agency (MHRA) in their recent Drug safety update, reminding prescribers that NSAIDs should be prescribed with caution in people with established renal impairment, or who are at risk of renal impairment. Issued in June 2009.
April 2009 — minor update. Information added to the Contraindications, adverse effects, monitoring section, highlighting the rare risk of severe hepatic adverse effects when using celecoxib and etoricoxib, based on the summary of product characteristics for each drug. Issued in May 2009.
February 2009 — the supporting evidence on the risk of cardiorenal adverse effects has been updated with two new epidemiological studies that were highlighted by the MHRA as lending support to the view that some increase in thrombotic cardiovascular risk may apply to all NSAID users, irrespective of their baseline risk, but that the absolute increase in risk for 'healthy' users is very low. Issued in March 2009.
February to June 2008 — converted from PRODIGY guidance to CKS topic structure. The evidence-base has been reviewed in detail, and recommendations are more clearly justified and transparently linked to the supporting evidence.